Doctor Name: | MR. RONALD FRANZ RESTIVO |
NPI Number: | 1093084154 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSPT |
License Number: | 024948 |
Business Practice Address: | 7 Columbia Pl Port Washington, NY - 110502708 |
Business Phone Number: | 9176928343 |
Business Fax Number: | |
Mailing Address: | 7 Columbia Pl, PORT WASHINGTON |
State: | NY |
Postal Code: | 110502708 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/19/2011 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 024948 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |